CORONARY ANGIOGRAPHY FOLLOWING CARDIAC ARREST WITHOUT ST-SEGMENT ELEVATION: A MULTICENTER STUDY.

Background:  Ischemic heart disease is a leading reason of cardiac arrest outside the hospital. However, the best approach for treating successfully resuscitated cardiac arrest patients without ST-segment elevation myocardial infarction (STEMI) remains uncertain. Methods:  The primary endpoint of this multicenter study was survival at 90 days; secondary endpoints included duration of catecholamine support, myocardial injury, indicators of shock, length of time on mechanical breathing, ventricular tachycardia recurrence, significant bleeding, need for renal replacement therapy, acute kidney injury, neurologic status at ICU discharge, and time to reach the target temperature. Following neurological recovery, 152 patients who had suffered cardiac arrest but had not had STEMI were randomized to either quick coronary angiography or delayed coronary angiography, with PCI administered as needed. Results:  The immediate angiography category had 63.5% survival at 90 days (56 out of 123 participants), while the delayed angiography category had 66.2% survival (68 out of 95 patients). In the immediate angiography category, the median time to reach the goal temp. was 5.3 hours, while in the delayed angiography category, it took 4.6 hours. The remaining secondary endpoints showed no discernible differences between the categories. Conclusions:  Within the category of patients who underwent successful resuscitation following an out-of-hospital cardiac arrest and did not exhibit indications of STEMI, the overall survival at 90 days did not demonstrate a superiority between an urgent angiography method and a delayed angiography strategy. Recommendation:  Based on the findings of this study, there is no clear superiority between an urgent angiography approach and a delayed angiography strategy for patients who have been successfully resuscitated following an out-of-hospital cardiac arrest without indications of ST-segment elevation myocardial infarction (STEMI). Further research and clinical guidelines may be necessary to determine the most effective treatment approach for this patient population.

PREDICTIVE VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO FOR CORONARY ARTERY DISEASE: A PROSPECTIVE STUDY.

Introduction The goal of the current investigation was to assess the relationship between the occurrence of coronary artery disease (CAD) and the neutrophil-to-lymphocyte ratio (NLR). Additionally, we wanted to provide an appropriate NLR cut-off for the diagnosis of CAD.  Methods A total of 124 individuals underwent coronary angiography, and they were split into two groups: category 1 (people without coronary artery disease) and category 2 (those with coronary artery disease).  Results The findings revealed a statistically significant positive correlation (p< 0.05) between heightened concentrations of WBC, neutrophils, monocytes, NLR, hs-CRP, CPK-MB, and troponin I with the presence of the disease. Based on the findings of subcategory analysis, it was observed that the association exhibited a greater degree of significance (p< 0.04) within the male demographic and among individuals of advanced age. Of all the markers evaluated, the NLR exhibited the most robust predictive capacity for CAD, as indicated by the highest odds ratio of 1.395 (95% CI: 0.941–2.360; p = 0.04). The determined optimal cut-off value for the diagnosis of CAD was found to be 2.12 (p< 0.001), based on the NLR. The current investigation additionally identified a correlation between the NLR and other biochemical indicators, specifically hs-CRP, CPK-MB, and troponin I, utilizing quartile analysis.  Conclusion The NLR is a straightforward diagnostic indicator that has demonstrated efficacy in the identification of CAD within the Indian population. A defined threshold of 2.12 has been established for optimal diagnostic accuracy.  Recommendations The utilization of NLR, owing to its cost-effectiveness and convenient accessibility, can be utilized as an initial screening modality, particularly in smaller healthcare facilities, to assess the need for employing more expensive and time-consuming imaging techniques in the diagnosis of coronary artery disease

Inflation Targeting Venezuela’s Hyperinflation

Thesis advisor: Geoffrey SanzenbacherIn recent decades, an increasing number of countries have adopted inflation targeting (IT) as a framework for monetary policy, wherein the country's central bank attempts to steer actual inflation toward a projected target rate. However, the question still remains whether or not IT can work in low-income countries experiencing hyperinflation, such as Venezuela. One of the main challenges facing such countries is the lack of credibility of their monetary institutions. Inflation targeting may help restore this credibility by committing the central bank to a transparent and accountable monetary policy. This paper delves into the theory of inflation targeting, examines the benefits and challenges associated with IT, and discusses the specific challenges that Venezuela may face when adopting IT. The paper also emphasizes the importance of accurate economic data in developing effective monetary policies and argues that forecasting can play a critical role in predicting the effectiveness of IT in Venezuela. Empirical evidence from other countries that have implemented inflation targeting will also be used to provide insights into the potential benefits and challenges of this policy for Venezuela.Thesis (BA) — Boston College, 2023.Submitted to: Boston College. College of Arts and Sciences.Discipline: Departmental Honors.Discipline: Economics